Download DocumentsAgent FAQ: Florida Blue Accident Benefit changes
Overview and purpose
Q. Why are the Accident Benefits changing?
A. The enhancements are designed to provide members with stronger protection and greater value. Most benefit payouts are increasing (all except Wellness), so members will receive greater value when accidents occur. These updates reflect our commitment to meaningful coverage improvements. Members’ premium rates will not be changing.
Q. What products are impacted by the Accident Benefit changes?
A. The changes apply to Florida Individual (consumer) Accident Plans — both Plan 1 (low) and Plan 2 (high).
Timing and eligibility
Q. When will the new Accident Benefits go into effect?
A. The enhanced benefits go live in SalesConnect for new quotes on Oct. 16, 2025.
Q. Who is impacted by the Accident Benefit changes?
A. Both new and existing members:
- New members: Anyone purchasing a new Accident policy with a submission date on or after Oct. 16, 2025, will automatically receive the enhanced benefits, with no change in premium rate.
- Existing members: Policies with a submission date on or before Oct. 15, 2025, will be enhanced in phases. Those members will receive a mailed notification with an updated Schedule of Benefits and Outline of Coverage. All lives covered under the policy will receive the enhanced benefits.
Submission vs. effective date
Q. How does the policy’s effective date impact the benefit amount a member will receive?
A. Benefit amounts are determined by the submission date, not the effective date.
- Applications submitted on or before Oct. 15, 2025: Current (lower) benefits apply.
- Applications submitted on or after Oct. 16, 2025: Enhanced benefits apply.
Q. Why do some policies with the same effective date have different benefits?
A. Benefit levels are based on the application submission date, not the effective date. For example, two policies with a Nov. 1, 2025, effective date may have different benefits depending on whether their application was submitted on, before, or after Oct. 16.
Q. Can two members with the same effective date receive different benefit amounts?
A. Yes. If one application was submitted before Oct. 16, 2025, they’ll receive current benefits. If the other application was submitted on or after that date, they’ll receive enhanced benefits.
Benefit details
Q. What benefits have been enhanced and by how much?
A. All benefit amounts — except for the Wellness Benefit — have been increased. Increases range from 100% to 300%. Premium rates have not been changed.
Q. When will enhanced benefits be effective for existing policies?
A. Each member will be notified by mail of the benefit enhancements and the date the changes are effective. All eligible claims associated with a covered accident occurring on or after the effective date of the benefit enhancements will be paid the enhanced benefit amount(s).
Q. Can an existing member delay submitting a claim and submit it after their benefits are enhanced?
A. The benefit amount payable is based on the benefit schedule in effect on the date of the covered accident or wellness visit, not the submission date.
Q. Will members need to take any action to receive the enhanced benefits?
A. No action is needed. Existing policies will be automatically enhanced, and members will be notified by mail.
Q. Can members opt out of the enhanced benefits?
A. No. The enhancements are automatically applied to eligible policies to improve coverage. There is no opt-out option; however, a member can always cancel their policy at any time.
Q. Where can a member see the benefit amounts for their policy?
A. Benefit amounts are listed in the Outline of Coverage provided at purchase. A new Outline of Coverage will be mailed to members once their policy is enhanced to reflect the enhanced benefit amounts.
Premiums and payments
Q. Will a member’s premium change when the policy is updated?
A. No. This is NOT a premium rate change. Premiums will remain the same. The updates focus solely on enhancing benefits with no additional cost to the insured.
Q. Do the Accident Benefit changes affect how a member pays their premium?
A. No. Payment methods and premium amounts remain unchanged. Members can continue paying online via credit/debit card or bank draft through the member portal.
Member communication
Q. Will a member receive anything in the mail about their policy updates?
A. Yes. Members with existing policies will receive a mailed notification of a description and the effective date of the enhancements, including a new Schedule of Benefits and Outline of Coverage.
Q. How will a member know when their existing policy has been updated?
A. They’ll receive a mailed notification confirming the update, along with revised policy documents.
Agent support
Q. Can agents access a comparison chart showing old vs. new benefit amounts?
A. Yes. A comparison chart is available on the agent portal or can be requested from Sales Support to help explain the enhancements.
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